Rachel Reid, MD, MS, an internal medicine doctor at Brigham and Women’s hospital and a Management Leadership Track (MLT) participant. Dr. Reid has made great progress on her project to reduce costs and improve care during the post-discharge period, a high-risk point of care transition. Her pilot was part of a larger partnership between Partners Healthcare and Vidscrip—a patient engagement start-up that provides video-making software to medical professionals. Dr. Reid developed a set of disease-specific video discharge instructions aimed at improving patient comprehension, satisfaction, and self-management. These videos cover diagnoses selected to represent common discharge conditions that have a high burden of self-management and risk for post-discharge readmission or visits to the Emergency Department (ED). These diagnoses include: Chronic Obstructive Pulmonary Disease (COPD), Upper Gastrointestinal Bleeding, Congestive Heart Failure, and Pneumonia. (Click on each diagnosis to view the corresponding videos.) Patients view the videos on an iPad with their caregivers before leaving the hospital and receive HIPAA compliant links through which they can review these videos at home. Each video complements existing written instructions and includes disease-specific information around medications and follow-up care, general self-management strategies, and red flags” that should prompt patients to connect with their care team or visit the ED.
After collaborating with administrators and conducting outreach to nursing staff across the Department of Medicine, Dr. Reid and her collaborator, Sarah Post, MD, selected 6 general medicine units suited to quality improvement. Three of the units were chosen to be testing sites, while the other three were used as control units to measure the program’s impact. Medical teams shared the videos with patients via iPad, as well as information about the program to present to patients and caregivers.
Though the videos were well-received by both staff and patients, Drs. Reid and Post experienced challenges with implementation and project follow-up. Eligibility issues such as co-morbidities, language barriers, and post-discharge care plans complicated their ability to reach target enrollment numbers for the pilot. Follow-up analysis proved difficult as many patients were discharged to rehabilitation centers, mental care facilities, and transition housing organizations, and were thus either reliant on continuing care from medical teams or were unable to be reached for follow-up surveys.
Though these challenges precluded Drs. Reid and Post from collecting enough statistically significant data to prove the efficacy of the program, lessons learned through post-pilot analysis are already yielding new possibilities. For instance, Drs. Reid and Post determined that the videos can be tailored to specific patient cases, such as cardiovascular disease, diabetes, postoperative recovery, pediatrics, and home-bound patients. In addition, lessons learned—as well as the challenges faced by Drs. Reid and Post during implementation and analysis—will be instrumental to the Partners-wide initiative with Vidscrip to spearhead improved patient care while managing costs. Already, important insights gained through the piloting phase of this program are contributing to Partners-wide digital population health initiatives that will continue to improve operations and patient care.
Drs. Reid and Post will continue to deliver exceptional patient care while addressing some of today’s most complicated healthcare challenges. After graduation, Dr. Reid will join BWH’s Advanced Primary Care Associates as a clinician and the RAND Corporation as a health policy analyst. Dr. Post is still finalizing her post-graduation plans but has received numerous offers from research organizations and clinical practices across the country. Thanks to your generous support, talented early-career clinicians like Drs. Reid and Post can develop new programs that empower patients to be active participants in their own care. As hospitals and treatment centers explore how to leverage new technologies to improve care delivery, forward-thinking clinicians like Drs. Reid and Post will play pivotal roles in shaping the future of medicine.